TN 4 (08-12)

NL 00720.090 CIC Child-In-Care

CIC002 NO CHILD-IN-CARE (A10)

(Requested)

Caption: If You Disagree With The Decision

We cannot pay  (1)  benefits for the months of  (2)  because  (3)  not taking care of  (4)  child in those months.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: you

Choice 2: beneficiary name

Fill-in (2) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY through MM/CCYY

Fill-in (3) - Systems Generated

Choice 1: you were

Choice 2: he was

Choice 3: she was

Fill-in (4) - Systems Generated

Choice 1: Beneficiary's Name possessive

CIC003 MEDICAL IMPROVEMENT NOT EXPECTED MOTHER'S/FATHER'S BENEFITS (J60)

(Requested)

Caption: Things To Remember

 (1)  for benefits because doctors and other trained staff decided that  (2)  a disabled child in  (3)  care. However, we must review all disability cases. Therefore, we will review  (4)  child's case in 5 to 7 years. We will send  (5)  a letter before we start the review. Based on that review,  (6)  benefits will continue if  (7)  child is still disabled, but will end if  (8)  child is no longer disabled.

The decisions we made on  (9)  claim are based on information  (10)  gave us. If this information changes, it could affect  (11)  benefits. For this reason, it is important that  (12)  changes right away. We have enclosed a pamphlet, "When You Get Social Security Disability Benefits... What You Need To Know." It will tell  (13)  what must be reported and how to report. Be sure to read the parts of the pamphlet about what to do if your child goes to work or if your child's health improves. Also, remember to tell us if  (14)  child is no longer in  (15)  care.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: You qualify

Choice 2: Beneficiary Name qualifies

Fill-in (2) - Systems Generated

Choice 1: you have

Choice 2: he has

Choice 3: she has

Fill-in (3) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (4) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (5) - Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (6) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (7) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (8) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (9) - Systems Generated

Choice 1: your

Choice 2: Beneficiary Name possessive

Fill-in (10) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

Fill-in (11) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (12) - Systems Generated

Choice 1: you report

Choice 2: he reports

Choice 3: she reports

Fill-in (13) - Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (14) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (15) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

CIC004 REEXAMINATION PARAGRAPH SSA-831-U5 CONTAINS A REEXAMINATION DATE (J61)

(Requested)

Caption: Things To Remember

 (1)  entitled to benefits because  (2)  a disabled child in  (3)  care. The doctors and other trained personnel who made the disability decision expect  (4)  child's health to improve. Therefore we will review  (5)  child's case in  (6)  . We will send  (7)  a letter before we start the review. Based on that review,  (8)  benefits will continue if  (9)  child is still disabled. But they will end if  (10)  child is no longer disabled.

It is important that  (11)  changes to us right away. We have enclosed a pamphlet, "When You Get Social Security Disability Benefits . . . What You Need To Know." It will tell  (12)  what must be reported and how to report. Be sure to read the parts of the pamphlet about what to do if  (13)  child goes to work or if  (14)  child's health improves. Also remember to tell us if  (15)  child is no longer in  (16)  care.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: You are

Choice 2: Beneficiary name plus is

Fill-in (2) - Systems Generated

Choice 1: you have

Choice 2: he has

Choice 3: she has

Fill-in (3) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (4) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (5) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (6) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

Fill-in (7) - Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (8) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (9) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (10) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (11) - Systems Generated

Choice 1: you report

Choice 2: he reports

Choice 3: she reports

Fill-in (12) - Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (13) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (14) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (15) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (16) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

CIC006 NO CHILD-IN-CARE

(Requested)

Caption: None

We changed  (1)  monthly benefit to  (2)  beginning  (3) . We changed  (4)  benefit because  (5)  no longer  (6)  a child who is entitled to benefits in  (7)  care.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's Name Possessive

Choice 2: your

Fill-in (2) - Requested As A Money Amount In Format $$$$$.¢¢

Choice 1: Amount

Fill-in (3) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

Fill-in (4) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Fill-in (5) - Systems Generated

Choice 1: he

Choice 2: she

Choice 3: you

Fill-in (6) - Systems Generated

Choice 1: has

Choice 2: have

Fill-in (7) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

CIC007 CHILD-IN-CARE

(Requested)

Caption: None

We changed  (1)  monthly benefit to  (2)  beginning  (3) . We changed  (4)  benefit because  (5)  now  (6)  a child who is entitled to benefits in  (7)  care.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's Name Possessive

Choice 2: your

Fill-in (2) - Requested As A Money Amount In Format $$$$$.¢¢

Choice 1: Amount

Fill-in (3) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

Fill-in (4) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Fill-in (5) - Systems Generated

Choice 1: he

Choice 2: she

Choice 3: you

Fill-in (6) - Systems Generated

Choice 1: has

Choice 2: have

Fill-in (7) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

CIC008 CHILD-IN-CARE NO LONGER ENTITLED

(Requested)

Caption: None

We changed  (1)  monthly benefit to  (2)  beginning  (3) . We changed  (4)  benefit because the child in  (5)  care is no longer entitled to benefits.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's Name Possessive

Choice 2: your

Fill-in (2) - Requested As A Money Amount In Format $$$$$.¢¢

Choice 1: Amount

Fill-in (3) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

Fill-in (4) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Fill-in (5) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

CIC010 DISABLED MINOR CHILD ONSET ESTABLISHED LATER THAN ALLEGED SPOUSE'S (MOTHER'S/FATHER'S) MONTH OF ENTITLEMENT AFFECTED (J63)

(Requested)

Caption: Your Benefits

We found that your child became disabled  (1)  . This is different from the date given on the application. You are entitled to benefits because you have a disabled child in your care. Therefore, the date the child became disabled affects when your benefits start. You are entitled to benefits beginning  (2)  .

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: PIC C's DDO in the format Month DD, CCYY

Fill-in (2) - Systems Generated

Choice 1: DOED (for the disabled child in the NOTICE-PIC's care) in the format Month CCYY

CIC012 FPM CASE-MOTHER/FATHER ENTITLED-DAC IN CARE-3 YEAR REVIEW (J68)

(System Generated)

Caption: Things To Remember

You are entitled to benefits because doctors and other trained staff decided that your child is disabled under our rules. But, this decision must be reviewed at least once every 3 years. We will send you or your child a letter before we start the review. Based on that review, your benefits will continue if your child is still disabled, but will end if your child is no longer disabled.

Fill-in values:

NONE

CIC013 FPM CASE-MOTHER/FATHER ENTITLED-DAC IN CARE-5 OR 7 YEAR REVIEW (J69)

(System Generated)

Caption: Things To Remember

You qualify for benefits because doctors and other trained staff found that you have a disabled child in your care. However, we must review all disability cases. Therefore, we will review your child's case in 5 to 7 years. We will send you a letter before we start the review. Based on that review, your benefits will continue if your child is still disabled, but will end if your child is no longer disabled.

Fill-in values:

NONE

CIC014 FPM CASE-MOTHER/FATHER ENTITLED-DAC IN CARE-REVIEW BASED ON MRED (J70)

(System Generated)

Caption: Things To Remember

You are entitled to benefits because you have a disabled child in your care. The doctors and other trained personnel who made the disability decision expect your child's health to improve. Therefore, we will review your child's case in  (1)  . We will send you a letter before we start the review. Based on that review, your benefits will continue if your child is still disabled. But they will end if your child is no longer disabled.

Fill-in values:

Fill-in (1)

Choice 1: date of review

CICR11 DISABLED MINOR CHILD GIVEN A CLOSED PERIOD OF DISABILITY SPOUSE'S (MOTHER'S/FATHER'S) MONTH OF ENTITLEMENT AFFECTED (J64)

(Requested)

Caption: Your Benefits

To be entitled to Social Security Benefits, you must have a child in your care who is also entitled to benefits. And, that child must be under age 16 or disabled.

We have decided that your child became disabled according to our rules on  (1)  and was no longer disabled in  (2)  . Therefore, the first month for which we could pay you benefits is  (3)  . We could pay you for the month the disability ended and the following 2 months. This means that the last month for which you were entitled to benefits was  (4)  .

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: DDO in the format Month DD, CCYY

Fill-in (2) - Requested As A Date In Format Shown Below

Choice 1: EFD associated with T6 minus 3 months for BIC = C shown in Fill-in 1, in the format Month CCYY

Fill-in (3) - Systems Generated

Choice 1: DOEC in the format Month CCYY

Fill-in (4) - Requested As A Date In Format Shown Below

Choice 1: EFD Date associated with T6 minus 1 month for BIC = C shown in Fill-in 1, in the format Month CCYY

CICR12 PERIODIC REVIEW PARAGRAPH SPOUSE'S (MOTHER'S/FATHER'S) AWARD NOTICES WHERE A REEXAM IS NOT INDICATED (J62)

(Requested)

Caption: Things To Remember

You are entitled to benefits because doctors and other trained staff decided that you child is disabled under our rules. But, this decision must be reviewed at least once every 3 years. We will send you or your child a letter before we start the review. Based on that review, your benefits will continue if your child is still disabled, but will end if your child is no longer disabled.

Fill-in values:

NONE


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900720090
NL 00720.090 - CIC Child-In-Care - 08/17/2012
Batch run: 08/17/2012
Rev:08/17/2012